螺旋CT在肺动脉栓塞诊断中的价值

The value of ultrasound to diagnose subpulm onary effusion

目的:评价螺旋CT在诊断肺动脉栓塞中的作用。方法:16例肺动脉栓塞患者行螺旋CT肺动脉造影 (SCTA)检查,层厚3mm,扫描时间0.8s,对比剂注射速度3.5ml/s,总量100ml,扫描延迟时间15s。结果:16例 共644支,其中134支肺动脉及分支显示了栓塞,占20.8%。228支肺段肺动脉中,有56支显示肺动脉栓塞,占分 析肺动脉支的24.5%。204支亚段肺动脉中37支显示肺动脉栓塞,占分析肺动脉支15.4%。肺动脉栓塞的CT形 态:①直接征象为不同程度的肺动脉分支内充盈缺损。中心型充盈缺损17支,偏心型充盈缺损44支,附壁血栓型 34支,完全阻塞型39支。②间接征象胸膜下肺梗死灶,内乳动脉一侧增粗,肺纹理稀少,胸水,肺动脉高压。结论: 螺旋CT肺动脉造影是诊断肺动脉栓塞的快速、有效、无创伤的诊断方法。

Objective: To evaluate the function of spiral CT in the diagnosis of pulmonary embolism (PE). Methods: Sixteen patients suspected pulmonary embolism were examined by spiral CT angiography (SCTA ). The thickness of spiral scanning was 3mm and scan time was 0.8s. 100ml contrast medium were injected intravenously at a rate of 3ml/s and the delay time was 15s. Results: There were 644 branches in 16 patients we studied, and PE was detected in 134 branches(20.8%). For segmental pulmonary arteries, 24.5%showed PE, and for subsegmental pulmonary arteries 15.4% showed PE. The signs of SCT included: ①The direct sign : the filling defect in the pulmonary arteries branches at various degrees. 17 branches was central filling defect, 44 branches was eccentric filling defect, 34branches was embolism attached to the walls of host artery, 39 branches was total occlusion of the pulmonary arteries. ② The indirect signs: the dilatation of internal thoracic artery, subpleural infarction, reduced pulmonary vascular markings, pleural effusion, pulmonary hypertension. Conclusion: The spiral CT angiography was a fast, effective and non-invasive diagnosis method for pulmonary embolism, and played an important role in diagnosing pulmonary embolism in clinical application.